Hematuria
Also known as: Blood in the urine
What is it?
Hematuria means blood in the urine. There are
many reasons the child can have blood in his or
her urine. Some of these can indicate serious
problems while others may really not be a problem
at all. In general, we classify hematuria into two
types; blood that you can see with your own eyes
which we call "gross hematuria", and blood that is
present in smaller amounts indivisible to your
eyes but can be found by your doctor when testing
your child's urine or looking at it under the
microscope. This second kind of blood is called,
"microscopic hematuria".
Who gets it?
Hematuria can be a sign of kidney disease but
it can also be present in children who are ill
with non-kidney diseases, or occasionally in
children who exercise very heavily. Sometimes,
perfectly healthy people may have hematuria for
long periods of time with no obvious other kidney
problems.
What causes it?
Normally the kidneys filter the blood, allowing
water and waste products to escape into the urine
while holding back protein and red blood cells.
The blood is filtered through very small blood
vessels within the kidney and when these blood
vessels are damaged blood and or protein can leak
through the blood vessels and show up in the
urine. Rarely, the red color that you see, may not
be blood cells but may be due to damage to muscle
cells, which also gives the urine or reddish-brown
color.
What are the symptoms?
Blood in the urine generally causes no symptoms
of its own. However, the illness or problem that
causes the blood in the urine may produce its own
symptoms. Patients with kidney disease may have no
symptoms or they may have nonspecific symptoms
such as tiredness, looking pale, weight gain and
fluid retention. If your child has a kidney stone
the stone may produce some blood but it's the
passage of the stone that causes the pain and not
the blood itself. Even when there are large
amounts of blood in the urine your child may only
have some mild difficulty in urinating. Rarely
there may be clots of blood in the urine and
passing of these clots may be particularly
uncomfortable.
How is it diagnosed?
If your child has gross hematuria your doctor
will want to be certain that your child does not
have an acute problem. This will involve a
physical examination, examination of the child's
urine and probably several blood tests. Depending
on the results of these blood tests your doctor
may want to consult with a pediatric kidney
specialist about the best treatment for your
child.
If your doctor finds that your child has
microscopic hematuria but is otherwise healthy,
your doctor will want to check your child's urine
several more times to be certain that the
microscopic hematuria is present in all of the
urine samples. The doctor will also check your
child's urine does not have an abnormal amounts of
protein present. Urine with both blood and protein
present is often a more serious problem and may
need more prompt attention.
Once your doctor determines that your son's
urine always contains contain small amounts of
blood, additional tests will have to be done. Most
often, this consists of blood tests but
occasionally X-ray or ultrasound studies are
necessary. Sometimes your doctor may want to
consult with a pediatric kidney specialist
regarding your child's microscopic hematuria.
What is the treatment?
There is no specific treatment for blood in the
urine. Small amounts of blood in your child's
urine are not by themselves harmful. However, this
may be a sign of serious kidney disease and that
serious kidney disease may need treatment. Most
patients who to have normal blood tests and are
found to have small amounts of blood in urine and
will not require any treatment.
Self-care tips
Be sure to consult a doctor if you have any of
the symptoms listed above. Do not ignore any
amount of blood in the urine.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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